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Yoshida GJ, Saya H. Molecular pathology underlying the robustness of cancer stem cells. Regen Ther 2021; 17:38-50. [PMID: 33869685 PMCID: PMC8024885 DOI: 10.1016/j.reth.2021.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
Intratumoral heterogeneity is tightly associated with the failure of anticancer treatment modalities including conventional chemotherapy, radiation therapy, and molecularly targeted therapy. Such heterogeneity is generated in an evolutionary manner not only as a result of genetic alterations but also by the presence of cancer stem cells (CSCs). CSCs are proposed to exist at the top of a tumor cell hierarchy and are undifferentiated tumor cells that manifest enhanced tumorigenic and metastatic potential, self-renewal capacity, and therapeutic resistance. Properties that contribute to the robustness of CSCs include the abilities to withstand redox stress, to rapidly repair damaged DNA, to adapt to a hyperinflammatory or hyponutritious tumor microenvironment, and to expel anticancer drugs by the action of ATP-binding cassette transporters as well as plasticity with regard to the transition between dormant CSC and transit-amplifying progenitor cell phenotypes. In addition, CSCs manifest the phenomenon of metabolic reprogramming, which is essential for maintenance of their self-renewal potential and their ability to adapt to changes in the tumor microenvironment. Elucidation of the molecular underpinnings of these biological features of CSCs is key to the development of novel anticancer therapies. In this review, we highlight the pathological relevance of CSCs in terms of their hallmarks and identification, the properties of their niche—both in primary tumors and at potential sites of metastasis—and their resistance to oxidative stress dependent on system xc (−). Intratumoral heterogeneity driven by CSCs is responsible for therapeutic resistance. CTCs survive in the distant organs and achieve colonization, causing metastasis. E/M hybrid cancer cells due to partial EMT exhibit the highest metastatic potential. The CSC niche regulates stemness in metastatic disease as well as in primary tumor. Activation of system xc(-) by CD44 variant in CSCs is a promising therapeutic target.
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Key Words
- ABC, ATP-binding cassette
- ALDH, Aldehyde dehydrogenase
- BMP, Bone morphogenetic protein
- CAF, Cancer-associated fibroblast
- CD44 variant
- CD44v, CD44 variant
- CSC, Cancer stem cell
- CTC, Circulating tumor cell
- CagA, Cytotoxin-associated gene A
- Cancer stem cell
- DTC, Disseminated tumor cell
- E/M, Epithelial/mesenchymal
- ECM, Extracellular matrix
- EGF, Epidermal growth factor
- EMT, Epithelial-to-mesenchymal transition
- EpCAM, Epithelial cell adhesion moleculeE
- Epithelial-to-mesenchymal transition (EMT)
- GSC, Glioma stem cell
- GSH, reduced glutathione
- HGF, Hepatocyte growth factor
- HNSCC, Head and neck squamous cell cancer
- IL, Interleukin
- Intratumoral heterogeneity
- MAPK, mitogen-activated protein kinase
- MET, mesenchymal-to-epithelial transition
- NSCLC, non–small cell lung cancer
- Niche
- Nrf2, nuclear factor erythroid 2–related factor 2
- OXPHOS, Oxidative phosphorylation
- Plasticity
- Prrx1, Paired-related homeodomain transcription factor 1
- ROS, Reactive oxygen species
- SRP1, Epithelial splicing regulatory protein 1
- TGF-β, Transforming growth factor–β
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Affiliation(s)
- Go J Yoshida
- Division of Gene Regulation, Institute for Advanced Medical Research (IAMR), Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Saya
- Division of Gene Regulation, Institute for Advanced Medical Research (IAMR), Keio University School of Medicine, Tokyo, Japan
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Kim YR, Yoo JK, Jeong CW, Choi JW. Selective killing of circulating tumor cells prevents metastasis and extends survival. J Hematol Oncol 2018; 11:114. [PMID: 30201021 PMCID: PMC6131899 DOI: 10.1186/s13045-018-0658-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/27/2018] [Indexed: 11/13/2022] Open
Abstract
Distant metastasis is initiated by circulating tumor cells (CTCs), which are considered to be a determining factor for the degree of metastasis and the survival of cancer patients. Although CTC-based diagnostic approaches are being rapidly developed, limited studies have proven the benefits of CTC elimination, with most studies providing only hypothetical inference because of the technical difficulty in examining the effects of CTC elimination in vivo. We modified photodynamic therapy to specifically eliminate green fluorescent protein (GFP)-expressing CTCs and evaluated the therapeutic efficacy of CTC elimination. When circulating blood is illuminated with a blue laser (λ = 473 nm), the combination of GFP and photosensitizers induces a selective elimination of GFP-expressing CTCs, with limited effect on normal cells. In GFP-expressing cancer cell-infused or transplanted mice models, the treatment suppressed distant metastasis and extended the survival of the tumor-bearing mice. Taken together, CTCs are a core seed to be metastasized into secondary organs and elimination of CTCs may improve the survival of cancer patients.
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Affiliation(s)
- Yi Rang Kim
- Department of Hematology/Oncology, Yuseong Sun Hospital, Daejeon, 34084, Republic of Korea
| | - Jung Ki Yoo
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.,Department of Life and Nano-pharmaceutical Sciences, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, 03080, Republic of Korea
| | - Jin Woo Choi
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea. .,Department of Life and Nano-pharmaceutical Sciences, Kyung Hee University, Seoul, 02447, Republic of Korea.
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Tanriverdi O, Ogunc H. A case report of three patients with metastatic gastric cancer on hemodialysis who were treated with cisplatin-fluorouracil regimen. J Oncol Pharm Pract 2015; 22:345-9. [PMID: 25567516 DOI: 10.1177/1078155214567160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Gastric carcinoma is the first cause of death worldwide. In previous studies that included best supportive care and chemotherapy comparison, chemotherapy survival time was four to five months more than best supportive care. This time was reported as seven to nine months in cisplatin and fluorouracil therapy. We aimed to call attention to non-progression survival time which was being longer with cisplatin and fluorouracil therapy in three metastatic gastric carcinoma patients who were on hemodialysis due to chronic renal impairment related to diabetic nephropathy. We determined that this regimen was well tolerated with hemodialysis, and the median time to progression was eight months (range 7-10). This time was similar to the time results of previous studies. In our hypothesis, hemodialysis may increase the time to progression significantly and we aimed to discuss the hypothetical relation between dialysis membrane and circulating tumor cells.
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Affiliation(s)
- Ozgur Tanriverdi
- Faculty of Medicine, Department of Medical Oncology, Mugla Sitki Kocman University, Mugla, Turkey
| | - Handan Ogunc
- Nephrology Unit, Ordu Governmental Hospital, Ordu, Turkey
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Kamande J, Hupert M, Witek M, Wang H, Torphy R, Dharmasiri U, Njoroge S, Jackson J, Aufforth R, Snavely A, Yeh J, Soper S. Modular microsystem for the isolation, enumeration, and phenotyping of circulating tumor cells in patients with pancreatic cancer. Anal Chem 2013; 85:9092-100. [PMID: 23947293 PMCID: PMC3832346 DOI: 10.1021/ac401720k] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this manuscript, we discuss the development and clinical use of a thermoplastic modular microsystem for the high-throughput analysis of CTCs directly from whole blood. The modular system offers some innovative features that address challenges currently associated with many CTC platforms; it can exhaustively process 7.5 mL of blood in less than 45 min with recoveries >90%. In addition, the system automates the postselection CTC processing steps and thus, significantly reduces assay turnaround time (from selection to enumeration <1.5 h as compared to >8 h for many reported CTC platforms). The system is composed of 3 functional modules including (i) a thermoplastic CTC selection module composed of high aspect ratio (30 μm × 150 μm) channels containing anti-EpCAM antibodies that is scalable in terms of throughput by employing channel numbers ranging from 50 to 320; the channel number is user selected to accommodate the volume of blood that must be processed; (ii) an impedance sensor module for label-less CTC counting; and (iii) a staining and imaging module for the placement of released cells into a 2D array within a common imaging plane for phenotypic identification. To demonstrate the utility of this system, blood samples from patients with local resectable and metastatic pancreatic ductal adenocarcinoma (PDAC) were analyzed. We demonstrate the ability to select EpCAM positive CTCs from PDAC patients in high purity (>86%) and with excellent yields (mean = 53 CTCs per mL for metastatic PDAC patients) using our modular system. In addition, we demonstrate the ability to detect CTCs in PDAC patients with local resectable disease (mean = 11 CTCs per mL).
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Affiliation(s)
- J.W. Kamande
- Department of Chemistry, Louisiana State University, 232 Choppin Hall, Baton Rouge, LA 70803-1804, USA
| | - M.L. Hupert
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
| | - M.A. Witek
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
| | - H. Wang
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
| | - R.J. Torphy
- University of North Carolina, School of Medicine Chapel Hill, 321 S Columbia St, Chapel Hill, NC 27514, USA
| | - U. Dharmasiri
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
| | - S.K. Njoroge
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
| | - J.M. Jackson
- Department of Chemistry, University of North Carolina, Campus Box 3290, Chapel Hill, NC 27599-3290, USA
| | - R.D. Aufforth
- Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, University of North Carolina School of Medicine, 170 Manning Dr., Chapel Hill, NC
| | - A. Snavely
- UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, USA
| | - J.J. Yeh
- University of North Carolina, School of Medicine Chapel Hill, 321 S Columbia St, Chapel Hill, NC 27514, USA
- Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, University of North Carolina School of Medicine, 170 Manning Dr., Chapel Hill, NC
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC
- UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, USA
| | - S.A. Soper
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
- Department of Chemistry, University of North Carolina, Campus Box 3290, Chapel Hill, NC 27599-3290, USA
- Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
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Liu G, Neumeister M, Reichensperger J, Yang RD. Therapeutic potential of human adipose stem cells in a cancer stem cell-like gastric cancer cell model. Int J Oncol 2013; 43:1301-9. [PMID: 23900519 DOI: 10.3892/ijo.2013.2039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 06/03/2013] [Indexed: 11/05/2022] Open
Abstract
Cancer stem cells (CSCs) or circulating tumor cells play an important role in tumor initiation, invasion, metastasis and resistance to anticancer therapies. Therapies that target gastric tumor CSCs have potential clinical application for preventing malignant gastric tumor progression and metastasis. We isolated CD44+ gastric cancer cells from the gastric cancer cell line AGS and Hs746T cells and maintained the cells in a novel stem cell culture. The cells were kept in an undifferentiated proliferative state and we characterized their cancer stem cell properties and chemotherapy-resistance behavior. The CD44+ cancer cells were also co-cultured with human adipose stem cells (ADSCs) to determine the chemotherapy-promotion effects of the adipose cells on the CD44+ cancer cells. The CD44+ gastric cancer cell model is a non-adhesion, 3-dimensional, spheroid phenotype. The non-adherent CD44+ cells have cancer stem cell properties and are highly chemo-resistant. However, these cells regained chemo-sensitivity when re-attached to an extracellular matrix-coated attachment surface. The human adipose stem cells significantly promoted the chemo-sensitivity of the non-adherent CD44+ gastric cancer cells. Integrin α2/β2 and the Wnt signaling pathways are involved in the mechanisms. We concluded that the in vitro non-adherent CD44+ gastric cancer cell model resembles the circulating gastric tumor cells in vivo. Introduction of an appropriate attachment surface significantly promotes chemo-sensitivity of the non-adherent CD44+ gastric cancer cells. The human adipose stem cells function as a 'living vehicle surface' for such a purpose in vivo.
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Affiliation(s)
- Guangming Liu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL 62794, USA
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